1 Recommendations

Guidance

1.1 Current evidence on the safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI‑S) for treating morbid obesity shows that there are well-recognised complications. Evidence on efficacy is limited in both quality and quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wishing to do SADI‑S for treating morbid obesity should:

Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.

1.3 Clinicians should review local clinical outcomes and enter details about all patients having SADI‑S for treating morbid obesity onto the National Bariatric Surgery Registry.

1.4 Patient selection should be done by a multidisciplinary team experienced in managing morbid obesity.

1.5 Treatment should be done by surgeons with specific training in the procedure, in centres with expertise in the treatment of morbid obesity.

1.6 NICE encourages further research into SADI‑S for treating morbid obesity, particularly research examining long-term outcomes. NICE may update the guidance on publication of further evidence.